Browsing by Author "Shiferaw, Solomon(PhD)"

Now showing 1 - 4 of 4
  • No Thumbnail Available
    Item
    Assessment of Long Acting and Permanent Contraceptive Methods Utilization and Associated Factors among Female Antiretroviral Therapy Attendees in Gondar Town, North West Ethiopia, 2014
    (Addis Ababa University, 2014-06) Demessew, Yordanos; Shiferaw, Solomon(PhD)
    Background: The prevalence of unintended pregnancy is high among HIV-positive women. Although there is higher motivation among HIV-positive women to avoid unintended pregnancy and desire for use of highly effective contraception, long acting and permanent contraceptive methods usage remained low. Preventing unintended pregnancy among women living with HIV is an important component of prevention of mother-to –child transmission (PMTCT), yet only a little is known about LAPMs use among women who are on ART in Gondar town, North West Ethiopia. Objective: To determine long acting and permanent contraceptive methods utilization and associated factors among female antiretroviral therapy attendees in Gondar town, North West Ethiopia, 2014 Method: Institution based cross-sectional study was conducted by interviewing 480 women of reproductive age (15–49years) that were selected using systematic random sampling technique from a list of ART attendees in government health facilities. Structured and pretested Interviewer administered questionnaire was used to obtain information from the respondents. Descriptive, bivariate, and multivariate methods were used to analyze utilization of LAPMs and the factors associated with LAPMs utilization. Result: Two hundred fifty six (85.0%) of the sexually active women were using some modern form of contraception. The current utilization rate of LAPMs (alone or with condom) was 62(24.1%). Women who had high knowledge [AOR=2.59, 95% CI [1.04, 6.45] and ever had been pregnant since the commencement of ART [AOR= 2.68, 95%CI [1.21, 5.93] had an increased odds of using LAPMs. Moreover, those women who had discussion about family planning with health care provider [AOR=2.69, 95% CI [1.18, 6.15] were more likely to use LAPMs. Conclusion and recommendation: The finding discloses that the general usage of contraceptive amongst sexually active women on ART was high though specific usage of LAPMs was found to be low. Based on the finding, there is a need to improve the implementation of integrated Family Planning service with ART service and improve counseling service that emphasized on LAPMs use
  • No Thumbnail Available
    Item
    The Effect of School Environment on Overweight/Obesity among Private School Adolescents in Addis Ababa, Ethiopia: 2016
    (Addis Ababa University, 2016-06) Moges, Tsedey; Shiferaw, Solomon(PhD); Yirgu, Robel
    Introduction: Obesity was formally recognized as a global epidemic in 1997 by World Health Organization (WHO). It has more has more has more has more than doubled in children and quadrupled than doubled in children and quadrupled than doubled in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. In our country, among adolescents, high magnitudes have been shown especially in private schools (10-23%). Though there are studies that have showen the magnitude and individual level determinants, little is known about environmental-level determinants especially school environment and particularly adequacy of space in schools. School environment could affect largely since adolescents spend majority of their time in schools. Objectives: The study was aimed at comparing the magnitude of overweight and obesity among adolescents in private schools with and without adequate space for physical activity and exploring other environmental and individual-level determinants among private school adolescents in Addis Ababa, Ethiopia. Methods: School based comparative cross-sectional study was conducted among adolescents 10-19 years old. A total of 20 private schools were included in the study in which 10 were with adequate space and the rest 10 without adequate space for physical activity. A three stage random sampling technique was used to select the study participants. Adolescents were interviewed using pre-tested structured questionnaire. Weight and height measurements were done using standardized weighing scales and measuring boards respectively. Body Mass Index (BMI) for age Z-score was compared to WHO 2007 growth reference standards using WHO Anthro plus version 1.0.4 software. Data were entered and cleaned using EpiData 3.1 and all statistical tests were done using STATA version 12.1 software. Descriptive statistical tests, bivariate and multivariate logistic regression analysis were done to identify factors associated with overweight and obesity. Results: Out of the sampled adolescents, 1277 respondents participated in the study with response rate of 99.3%. The overall magnitude of overweight & obesity among the study participants was 17.0% which was significantly higher in schools without adequate space for physical activity (19.4% versus 14.6%) with p-value of 0.01. In the bivariate analysis, adolescents in schools without adequate space for physical activity 12 had 1.86 times higher odds of being in lower physical activity level and 1.41 times higher odds of being overweight/obese with p-value of 0.001 and 0.041 respectively. The partial correlation between adequacy of space and overweight/obesity accounting for the explanatory power of physical activity was also significant with partial correlation coefficient 0.06 and p-value 0.0341. Those in the middle wealth quintile, low Physical activity, traveling with private car from home to school, irregular breakfast consumption and ≤ 3 meals per day also had increased odds of being overweight / obese in the multivariate analysis. Conclusions: The findings of the study gave insight on the effect of inadequate space in schools as an important contributor to physical inactivity and a higher burden of overweight and obesity. Low physical activity and traveling with private car were also found to be significant factors associated with overweight and obesity among private school adolescents. Recommendations: Based on the the results of this study, it is important that officals responsible for urban development and licensing of private schools consider availability of a reasonably adequate space for schools and work with relevant regulatory bodies to ensure implementation according to the guidelines. School officials should design their schools in a way having adequate space for physical activity. Lastly the school community and the general public should promote adolescents to be physically active and walk to schools.
  • No Thumbnail Available
    Item
    HIV and Unintended Pregnancy Risk Perception and Contraceptive Use among Youth in Debre Birhan District, Ethiopia
    (Addis Ababa University, 2010-06) Arega, Tegene; Shiferaw, Solomon(PhD)
    Background --Young people have special sexual and reproductive health needs. Because of their low use of reproductive health service and their relatively high risk of being exposed to inaccurate or incomplete information, they are affected by HIV and other Sexually Transmitted infections (STIs) and experiencing unintended pregnancy. Objective--to assess HIV and unintended pregnancy risk perception and contraceptive use among youth in Debrebrhan District, Amhara Region. Methodology--a community based cross-sectional survey of 400 youths aged 15-24 years and 4 FGDs composed of two men and two women groups conducted in Debrebrhan District , in the eastern part of the country, from February 2010 to March 2010. Two-stage cluster sampling technique was employed, out of nine kebeles in the district; five kebeles were selected by simple random sampling. Respondents from each household were selected using a systematic sampling technique. Data analysis for the quantitative part was analyzed using EPI info version 6 and SPSS version 11 for windows and the qualitative part was manually summarized. Result--About 45% of the respondents were sexually active. The mean age at first sexual intercourse was 19.9+ 2.9years. Among the sexually active respondents 36.5% had ever used contraceptives and 35.9% use contraceptives consistently. The leading determinants of contraceptive use were to prevent unwanted pregnancy and HIV (accounting 35.3%) followed by limit births. Risk perception to HIV and unintended pregnancy was 9.8% and 18.2% respectively. Risk perception to HIV was associated with age of first partner consistent condom use and khat chewing Risk perception to pregnancy was associated with consistent contraceptive use Conclusion--despite the high knowledge the youths have on HIV and unintended pregnancy and contraception, contraceptive use and risk perception to HIV and unintended pregnancy is still low. Attitude to wards reproductive health services is the barrier to contraceptive use. Peer-based interventions and negotiate contraceptive use are important for promotion contraceptive use
  • No Thumbnail Available
    Item
    Impact of Food and Nutrition Security on Adherence to Anti-Retroviral Therapy (ART) and Treatment Outcomes among Adult PLWHA in Dire Dawa Provisional Administration
    (Addis Ababa University, 2007-06) Seifu, Abiy; Tesfaye, Fikru(PhD); Shiferaw, Solomon(PhD)
    Background: Adherence to Anti-Retroviral Therapy (ART) is critical for optimal virologic suppression and improved CD4+ cell count that in turn determines the survival of People Living with HIV/AIDS (PLWHA) on ART. So far a range of predictors of adherence to ART in many different social and cultural settings have been identified. However, household food and nutrition security as predictor of adherence to ART is less understood. Objective: The main objective of this research project is to assess the effect of household food and nutrition security on adherence to ART and treatment outcomes. Method: A cross-sectional study was conducted to assess the effect of household food and nutrition security on adherence to ART and treatment outcomes. Both quantitative and qualitative research methods were applied to triangulate the findings of one with another. Adult PLWHA on ART for at least 3 months were the study participants. Availability of enough food/money to buy one, behavioral and subjective questions, meal frequency, dietary diversity, food aid and BMI were used as indicators to measure the household food and nutrition security situation of PLWHA and self-reported adherence as an indicator to measure adherence to ART. Change in CD4+ cell count, body weight, functional status and frequency of opportunistic infections were used to measure treatment outcomes. Result: Based on food security assessment core module close to 90% of PLWHA on ART in Dire Dawa were food insecure and 30.1% had at least mild malnutrition. On patient self report of adherence 96.6% of them were adherent to 95% of the ART drugs prescribed. The median change in CD4 count after 6 months and the median change in weight after 3 months of ART were 116 (IQR 82-182) and 3kg (IQR 1-6kg) respectively. Reported diarrhea and lung disease among the study participants were 17.9% and 54.1% respectively. Food and nutrition security indicators were associated with treatment Impact of food and nutrition security on adherence to ART and treatment outcomes AAU, FM, DCH, RH specialty track IX outcomes. Food aid contributed to functional improvement (OR 1.89, 95% CI 1.20-2.97). Dietary diversity and meal frequency were significantly positively correlated with change in weight and change in CD4 count respectively (p<0.05). Pre-ART nutritional status was significantly negatively correlated with change in weight after 3 months of ART (p<0.001). Discussion: Food and nutrition insecurity is a serious problem of PLWHA on ART. Overcoming all the odds to adhere to the treatment PLWHA in the present study were adherent to ART more than any documented adherence findings. But food and nutrition insecurity was silent factor that impede treatment outcomes. Food aid, dietary diversity and meal frequency were positively associated with functional improvement, weight gain and CD4 increase. Pre-ART nutritional status was negatively correlated with weight gain indicating better improvement among severely malnourished. Current malnutrition was significantly associated with reported opportunistic infections. Conclusion and recommendations: The mere success in achieving high level of adherence among PLWHA taking ART should not undermine the impact of food and nutrition security on the treatment outcomes which is the ultimate goal of the program. Lack of food to take with medication is the main reason for those few non-adherents and food ration improved functional status of PLWHA on ART. Food aid as relief together with a sustainable income generating activities need to be included in ART program.